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Valve-sparing aortic root replacement in patients with Marfan syndrome avoids the complications of a prosthetic heart valve, particularly life-long anticoagulation therapy. Despite proven durability and excellent event-free survival, the majority of cardiac surgeons have not adopted this approach. Here, Stephen Westaby suggests that the time is right for a change in the surgical guidelines and explains that an early, elective valve-sparing operation can transform the long-term prognosis of patients with Marfan syndrome.
In this month's Case Study, George and colleagues present a case of antiphospholipid syndrome. The IgG anti-β2GPI antibodies isolated from this patient enhanced experimental atherosclerosis and attenuated plaque stability in apolipoprotein-E-knockout mice.
In this month's Case Study, Versaci and colleagues present a case of congenital coronary artery fistula originating from the left anterior coronary artery and draining into right ventricle, in conjunction with an aneurysm of the left anterior descending artery. The high risk of rupture lead the authors to close the fistula surgically using normothermic cardiopulmonary bypass.